Vascular dysfunction plays a pivotal role in the development of systemic complications associated with arterial hypertension and diabetes. The endothelium, or more specifically, various factors derived from endothelial cells tightly regulate vascular function, including vascular tone. In physiological conditions, there is a balance between endothelium-derived factors, that is, relaxing factors (endothelium-derived relaxing factors; EDRFs) and contracting factors (endothelium-derived contracting factors; EDCFs), which mediate vascular homeostasis. However, in disease states, such as diabetes and arterial hypertension, there is an imbalance between EDRF and EDCF, with a reduction of EDRF signalling and an increase of EDCF signalling. Among EDCFs, COX-derived vasoconstrictor prostanoids play an important role in the development of vascular dysfunction associated with hypertension and diabetes. Moreover, uridine adenosine tetraphosphate (Up4A), identified as an EDCF in 2005, also modulates vascular function. However, the role of Up4A in hypertension-and diabetes-associated vascular dysfunction is unclear. In the present review, we focused on experimental and clinical evidence that implicate these two EDCFs (vasoconstrictor prostanoids and Up4A) in vascular dysfunction associated with hypertension and diabetes. Abbreviations AA, arachidonic acid; AICAR, 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside; AMPK, AMP-activated protein kinase; CDK2, cyclin-dependent kinase 2; cPLA2, cytosolic PLA2; DOCA, deoxycorticosterone-acetate; E2, 17β-oestradiol; ECs, endothelial cells; EDCF, endothelium-derived contracting factor; EDHF, endothelium-derived hyperpolarizing factor; EDRF, endothelium-derived relaxing factor; EPA, eicosapentaenoic acid; ER, endoplasmic reticulum; ET-1, endothelin-1; GK, Goto-Kakizaki; GPER, G protein-coupled oestrogen receptor; HETEs, hydroxyeicosatetraenoic acid; HO-1, haem oxygenase-1; HUVEC, human umbilical vein endothelial cells; L-NAME, N G -nitro-l-arginine methyl ester; L-PGDS, lipocalin-type PGD synthase; MLC20, myosin light chain 20; NO, nitric oxide; NSAIDs, non-steroidal anti-inflammatory drugs; OLETF, Otsuka Long-Evans Tokushima Fatty; OPN, osteopontin; PDGFR, platelet-derived growth factor receptor; PGI2, prostacyclin; PGIS, prostacyclin synthase; ROCK, Rho kinase; ROS, reactive oxygen species; S6K, S6 kinase; SHR, spontaneously hypertensive rats; SMCs, smooth muscle cells; STZ, streptozotocin; TP, TxA2/endoperoxide receptor; TxA2, thromboxane A2; TxS, thromboxane synthase; Up4A, uridine adenosine tetraphosphate; VP, vasopressin; WKY, Wistar-Kyoto ratsThe endothelium plays a pivotal role in the regulation of vascular tone (Vapaatalo and Mervaala, 2001;Pries and Kuebler, 2006;Flammer and Luscher, 2010;Toda et al., 2010;Flammer et al., 2012; Favero et al., 2014). In response to mechanical forces (e.g. shear stress) and endogenous ligands, endothelial cells (ECs) release a diversity of factors that mediate or directly induce vascular smooth muscle contraction or relaxation (Vapaatalo and Me...